East Texas cases show healthy not immune to West Nile virus
By Sarah Thomas firstname.lastname@example.org
Oct. 6, 2012 at 11 p.m.
They were healthy and athletic East Texas adults, not at all the profile health officials said are most at risk from West Nile virus.
But that was before both were bitten by mosquitoes carrying the West Nile virus. And what happened in both cases illustrates how difficult it can be to diagnose the illness and the long-lasting effects it can have on those who contract it.
Though health officials warn the virus is most dangerous to children, the elderly and those with underlying medical conditions, Steven Self and Chelsy McCormick fit neither of those categories.
But they are among the faces of the illness that, this year, has stricken more than 1,550 Texans and killed more than 70.
McCormick, 28, was diagnosed with West Nile in early September after suffering flu-like symptoms for several days. Self was diagnosed with the mosquito-borne illness in August 2005 when he was 38. And while the virus is gone, its long-lasting damage lingers.
<strong>Getting a grasp</strong>
"I can hold things now," Self said this past week. "I can throw a baseball again, where when it first happened, it would just fall out of my hand."
Self, owner of Self Insurance in Longview, said he began realizing something was wrong back in 2005 when he lost feeling in his right arm.
"I couldn't use my arm, and I felt like I had the flu," Self said. "I was tired, and I just couldn't function."
Within hours, his condition worsened.
"Later that evening, in the middle of the night, I lost the use of my legs," he recalled.
Even though he knew something bad was happening, he didn't want to admit it.
"I didn't want to go to the doctor. I was active and healthy, and I had never been sick before, never been hospitalized," Self said.
Two days after the first signs of trouble showed up in Self's arm, his father took him to the hospital where doctors performed numerous tests to eliminate any illness that could manifest itself in the symptoms Self was experiencing.
At one point, he underwent three MRIs because of his severe tremors.
"I had the shakes really bad," he said. "I couldn't keep my body still enough for them to get a reading."
'I was going to die'
Self spent 14 days in an area hospital, where doctors feared the worst.
"They basically told me I was going to die," Self said. "They said I had a 33 percent chance to live, a 33 percent chance to be a quadriplegic and a 33 percent chance to recover over a long period of time."
Despite the grim prognosis, Self beat the odds and got back on his feet after undergoing occupational and physical therapy.
"They just couldn't figure it out at first," Self said. "In my case, I was one of the first they had seen. They just hadn't seen (West Nile) here before."
Although he was diagnosed with West Nile neuroinvasive disease, it was what the virus triggered inside his body that caused the paralysis.
"They told me it was something called transverse myelitis," he said.
The infection caused nerve damage throughout the right side of Self's body, but his right arm took the biggest hit.
Transverse myelitis is a neurological disorder caused by inflammation across a segment of the spinal cord. The inflammation can damage or destroy myelin, the fatty insulating substance that covers nerve cell fibers. Such damage causes nervous system scars that interrupt communications between the nerves in the spinal cord and the rest of the body.
In Self's case, his spinal cord can no longer communicate properly with some of the nerves in his right arm and right hand.
<strong>Seven years later</strong>
Today, seven years after the virus invaded his body, some tasks remain impossible for him.
"I can't fire a gun with my right hand because I just don't have enough trigger pull," he said.
And when he realized Texas was in the midst of another West Nile outbreak this past summer, he had instant sympathy for the victims and their families.
"I just feel sorry for them," Self said. "It just puts you back in the place where you were when you got it."
As of Thursday, West Nile illness had killed 71 people in Texas; 723 people had tested positive for West Nile neuroinvasive disease and 834 people had tested positive for West Nile fever, according to the Texas Department of State Health Services.
Nationwide, 3,969 cases of human West Nile have been diagnosed, the federal Centers for Disease Control and Prevention reported Thursday, including 163 deaths. It is the most cases reported through the first week in October since 2003.
<strong>Like flu, but worse</strong>
McCormick was diagnosed with West Nile fever Sept. 5 after a week-long battle with severe gastrointestinal problems, headaches and a constant fever.
The 28-year-old mother from Pittsburg plays in a co-ed baseball league. She said she thinks she contracted the illness that knocked her out of work for a week while she was on the baseball diamond.
"I always used (insect repellent) because all my life I've been getting bit by mosquitoes," McCormick said. "But by the end of the night, I still would end up with at least one bite."
<strong>And one bite was all it took.</strong>
McCormick went to a hospital Aug. 27, after she was unable to get out of bed. She was there for a week.
"It was like the flu but worse," she said.
The week included a battery of tests including general blood analysis, urinalysis and CT scans. Doctors also tested for mononucleosis, Hepatitis and gallstones - starting with a general blood test on a Monday.
"They called me back on Tuesday because my AST liver enzymes were 541," she said. "The normal range is five to 40."
Now, McCormick said she worries she incurred unnecessary medical bills because of all the tests doctors ran before they finally decided to test for West Nile.
<strong>Exhaustion to blame?</strong>
"On Monday or Tuesday, I mentioned to my doctor that I thought it was West Nile, but he wasn't inclined to think it was because I didn't fit the profile," she said.
McCormick said she thinks she experienced severe symptoms because she was exhausted.
"I wore my body down working all week, and every night Monday through Thursday we had a game," she said. "We went to a Rangers game on Friday and on Saturday we had a midnight tournament."
She left the tournament before championship play.
"I just didn't have the strength to play anymore," she said.
Though it's been more than a month since her diagnosis, McCormick still is dealing with the virus' effects.
"I started playing ball again two weeks ago, and I don't have any endurance," she said this past week.
But she said she is thankful her case wasn't worse, and she was relieved when she finally was diagnosed with West Nile fever, the less severe form of the illness.
"I wanted validation for why I felt so bad," she said. "Even though mine wasn't the neuroinvasive, it was still scary because you just don't know what could come of it."
Curtis Allen, spokesman for the CDC, said he is not surprised that two otherwise healthy people had succumbed to the virus. It is not unheard of.
"We know those at greater risk are the young, the elderly and those who have medical conditions, but that doesn't mean other people are not going to get it," he said.
And no one has figured out why some people develop West Nile fever, like McCormick, and others develop neurological problems, like Self.
Allen said both forms of the disease develop from the same virus.
He said a mosquito carrying West Nile could bite three people and the virus could manifest itself differently in each of them - no symptoms, flu-like symptoms or more serious neurological effects.
"We just don't know," Allen said. "We do know that most people don't develop the neuroinvasive form."
He said those who seek medical treatment for flu-like symptoms are sometimes tested for other illnesses because a lot of illnesses manifest the same symptoms. Those include strep throat, influenza, mono and meningitis.
About one in five people infected with the virus will develop flu-like symptoms, including fever, body aches, vomiting, headaches, joint pain and diarrhea; fewer than 1 percent will develop some kind of neurological illness, according to the CDC.
"Ten percent of those who develop a neurological infection will die," Allen said.
He said those who live can experience symptoms for several weeks.
"There is no medical treatment for the disease nor are there any vaccines to prevent it," Allen said. All physicians can do is "provide care, treat the symptoms."